--- title: "Does Online Trauma Therapy Work? | McFadden Institute" url: https://mcfaddeninstitute.com/resources/does-online-trauma-therapy-work description: "An honest look at trauma therapy by video: what changes on screen, why many people find it easier, and when in-person care is the better choice." lang: en --- Resources # Does online trauma therapy work? Updated September 29, 2026 It's a fair question. Trauma work sounds like the kind of thing that should happen in a room, face to face, with a box of tissues on the table. Doing it through a laptop can feel a little odd, or even a little risky. I work entirely by secure video, so I have an obvious stake in the answer. I'll try to be straight with you anyway: what video changes, what it doesn't, why many people find it easier, and when it isn't the right choice at all. ## What video changes, and what it doesn't What changes is mostly logistics. There's a screen between us instead of a coffee table. I can see your face and some of your posture, not your whole body. We both depend on a decent internet connection. And you're responsible for your own space, which I'll come back to. What doesn't change is the conversation, and in this work the conversation is most of it. Rapid Resolution Therapy (https://mcfaddeninstitute.com/approach/rapid-resolution-therapy) is direct and conversational. It works with how the mind is holding an experience, not with anything that requires us to be in the same room. The questions, the pauses, the moments where something shifts and you notice it: all of that carries over well. There's nothing to hand you, no equipment to set up, no exercises that need me standing next to you. That's part of why this particular kind of work suits video. ## Why many people find it easier For a lot of people, the hardest part of therapy is getting there. Driving across town, finding parking, sitting in a waiting room hoping nobody you know walks in, then driving home afterward while your mind is still full. Video removes all of that. Being in your own space can also help you settle. You're on your couch or at your kitchen table, with your own blanket and your own mug. For people who find new rooms and new people stressful, that familiarity can make it easier to talk. And when the session ends, you're already home. You can sit for a while instead of merging onto the interstate. It also opens things up geographically. Someone in a small town in the Panhandle can work with a clinician anywhere in the state, rather than choosing from whoever happens to be within driving distance. ## What can get in the way The biggest one is privacy. If you share a small apartment, or your home is rarely empty, finding 90 minutes where nobody can overhear you can be genuinely hard. It matters, because it's difficult to say what you really think when you're half listening for footsteps in the hall. The second is connection. A frozen screen at a tender moment is frustrating. It's rarely a disaster, but it's worth testing your setup ahead of time. The third is distraction. Phones, notifications, the dog, the doorbell. In an office those are left outside. At home you have to leave them outside yourself. There's a practical checklist in how to prepare for a telehealth session (https://mcfaddeninstitute.com/resources/preparing-for-telehealth). ## When in-person or more support is the better choice Video isn't right for everyone, and it isn't right for every situation. If you're in crisis, having thoughts of harming yourself, or in a situation where you aren't safe, you need faster and more hands-on support than a scheduled online session can offer. If you're in crisis, call or text 988 (Suicide & Crisis Lifeline). For emergencies, dial 911. Some people also simply prefer being in a room with someone. If you know that about yourself, it's worth trusting. And if you need a higher level of care, like a program that meets several times a week, a local provider will be better placed to offer it. I'd rather say so than have you struggle with the wrong format. ## The Florida rule Because I'm licensed in Florida, you need to be physically in Florida at the time of each session. It's a licensing rule, not a preference, and it applies even if you live here and happen to be traveling that day. Within the state, location doesn't matter. The service areas page (https://mcfaddeninstitute.com/service-areas) lists the cities I've written about, but anywhere in Florida with a private space and a steady connection works. ## So, does it work? For many people, yes, video is a perfectly good way to do this work, and sometimes a better one. It depends on the person, the space, and what they're dealing with. I won't promise any particular result, by video or otherwise. RRT isn't magic, and it doesn't work for every person on every issue. If you're curious whether it could suit you, the free 15-minute consultation is a low-stakes way to find out. You can also read more on the trauma and PTSD (https://mcfaddeninstitute.com/specialties/trauma-and-ptsd) page. ## Setting up for the first time If you've never done anything like this on a screen, the first few minutes can feel awkward. That's normal and it passes. It helps to join a couple of minutes early, check that your camera and sound work, and settle into your seat before we start. A glass of water within reach is a good idea. You don't need special equipment. A laptop, tablet or phone with a camera is enough. What matters more is where you sit: somewhere quiet, with a door you can close, and a light in front of you rather than behind. ## A note on what I can't see On video, I miss some of what I'd notice in a room: your feet tapping, your hands in your lap. I compensate by asking more. How is that landing? What's happening in your body right now? You may find you notice more about yourself when someone asks. And if you ever feel I've missed something, say so. ## Questions people ask ### Is video as private as an office? Sessions run over secure video, and what you say is confidential within the usual legal limits. The part you control is your own space. A room with a closed door, or a parked car, where no one can overhear, makes a real difference. ### What if I get upset on camera? Then you get upset, and we slow down. There's nothing embarrassing about it. You can turn away from the camera, take a break, or grab some water. You set the pace. ### What if the connection drops? It happens. Reconnect when you can, and we pick up where we left off. Testing your setup before the session and sitting close to your router helps. Image: Sunrise over a Florida causeway above the bay (https://mcfaddeninstitute.com/__l5e/assets-v1/971efb9e-c896-4951-a3dc-63e67e321e24/causeway-dawn.jpg) Curious whether this could fit for you? Book a free consultation: https://mcfaddeninstitute.com/contact Rapid Resolution Therapy is a therapeutic approach, not a guarantee of specific results and not a substitute for medical care. Every person's experience is different and individual outcomes vary. 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